What is radiation therapy?
Radiation therapy, or radiotherapy, is the treatment of cancer and other diseases using ionizing radiation. This radiation can be delivered externally or internally.

How does radiation work?
Radiation therapy works by damaging the DNA in the cancer cell, thereby disabling the cancer cell from reproducing and growing. The cancer cells then die and the cancer shrinks.

Will I feel the radiation or will it hurt?
No, external beam radiation treatments are painless, like having an x-ray taken.  Although radiation therapy is not painful, it can cause unwanted side effects.  The skin where radiation is aimed may feel like it has been sunburned and will need to be protected from the sun.

Will I become radioactive?
External beam radiation does not cause you to become radioactive, and you pose no risk of radiation exposure to people near you. If you have a radioactive implant in place, some visitors, such as pregnant women and small children, will not be allowed to get too close and visiting time may be limited or restricted until the implant is removed. Your doctor or nurse will tell you when these precautions are necessary.

Are there risks involved with radiation therapy?
The radiation used to damage or destroy cancer cells can also damage normal cells.  When this happens, you may experience side effects. However, the risk of side effects is usually outweighed by the benefits of killing cancer cells. Any side effects will be carefully monitored by the radiation oncologist.

What should I know about the risks of radiation therapy?
The risks, problems, and side effects that can occur with radiation therapy depend on the type and the dose and the part of the body that is being treated. Radiation that involves the abdomen may cause diarrhea; radiation involving the head and neck can cause mouth sores.  The most common side effects of radiation are fatigue, mouth sores, and skin problems.  Before your treatments, your doctor will explain ways to help prevent or reduce potential side effects.

What are the typical side effects of radiation therapy?
The most common side effects of radiation therapy reported by patients are fatigue and skin irritation at the site of treatment.  Other side effects depend on the area of the body being treated and the dosage being given, such as:

• Dry or sore mouth or throat may occur when treatment is being given in the mouth, throat or neck area.

• Some coughing and excess mucus production may occur if treatment is given to the lung area.

• Mild nausea and/or diarrhea may occur if treatment involves the abdominal area.

Most of these side effects will go away on their own within 4 to 6 weeks after treatment is completed.  Some long-term effects may include changes in the color and elasticity of skin in the treatment area.  Discuss any concerns you may have about side effects and ask about medications to counteract them with the radiation oncologist before the start of your treatment.

Will the radiation therapy make me sick?
Most patients do not experience any nausea with radiation therapy, unless the area being treated with radiation is around the stomach.  If you experience nausea, report this and any other symptoms to your doctor.  Effective medications exist to reduce and/or prevent your symptoms.

Will I lose my hair?
No, you will not lose the hair on your head unless that is the area being treated.  Hair loss only occurs in the area that is being treated with radiation therapy.  For instance, if the area being treated is your arm, you can expect to lose the hair on that arm during the treatment.

How long will my radiation treatment take?
Most of the time, external beam radiation is delivered in daily treatments, or fractions, over a period of 5 to 7 weeks. The patient will generally receive these treatments Monday through Friday, and then have the weekend off. A daily fraction will take about 15-30 minutes in the treatment room; however, the actual treatment only lasts a few minutes.

Who will administer my radiation treatments?
A doctor who specializes in radiation therapy is called a radiation oncologist. The radiation oncologist will prescribe the type and amount of radiation treatment that is appropriate and work closely with a team of healthcare professionals in determining the best way to deliver that treatment. Those healthcare professionals may include the following:

• Radiation physicists are experts who make sure the machines are working properly and that they deliver accurate radiation doses. The physicist also works closely with the doctor in planning your treatment.

• Dosimetrists are specialists who work with the doctor and physicist to create the treatment plan and calculate the radiation dose delivered to the tumor and the surrounding normal tissues.

  Radiation therapists are professionals who position you and operate the machines to deliver the radiation treatment on the linear accelerator.

• Radiation oncology nurses are caregivers who will help coordinate your care, manage side effects, and help you and your family learn about your treatment.

Can someone come to my treatments with me?
Friends or family are welcome to accompany you to your treatments.  However, federal regulations prohibit anyone who is not a patient or a person wearing a film badge monitor to be in the radiation controlled area during the time radiation equipment is being operated. Those accompanying you will likely be asked to wait in the reception area during the treatment.  This also serves to protect the privacy of other patients.  Only patients and staff are allowed in the treatment area during treatment hours.

Can I continue my regular routine/activities while undergoing radiation treatments?
You should continue with your normal routines.  Most patients continue full-time occupations or leisure activities through the course of treatments.  When you feel tired, do not over exert yourself; take time to rest when needed.  Try to get plenty of sleep and maintain a healthy diet.

Will I be alone during my treatments?
Because radiation effects are accumulated and radiation therapists treat many patients each day, it would be a long-term health risk for them to be in the room during the radiation treatments.  To ensure that you are okay and your treatment delivery is going well, you will be in voice contact with your radiation therapists and constantly monitored by a video camera.  If you should need assistance, simply tell the therapists and they will terminate the treatment and immediately tend to your needs.

What cancers are treated with brachytherapy?
Brachytherapy is used predominantly to treat early stage prostate cancer; however, it may also be used in breast, cervical, head and neck, and other cancers.

What is involved in the implantation of a radioactive seed into the prostate (brachytherapy)?
For most of these patients, radioactive seed implantation into the prostate is a one-time, non-surgical, low-impact procedure. Radioactive seed implantation into the prostate is typically performed in an outpatient hospital setting by a team of physicians consisting of a urologist, radiation oncologist, and a radiation physicist. Spinal anesthesia is typically performed, but general anesthesia may occasionally be utilized. Some centers perform this procedure in their hospital operating rooms. Both outpatient and inpatient settings are acceptable. Most patients can return to normal activity, including work, within one to three days, with little or no pain.

Will radioactive seeds be painful?
After the implantation of radioactive seeds into the prostate, there typically is some soreness underneath the scrotum. Occasionally patients describe feeling like they are “sitting on a golf ball”. This is due to the slight swelling and bleeding associated with the surgery. It gradually resolves. Most patients require only mild analgesics like acetaminophen (Tylenol®). Narcotic pain medications are rarely required.

How soon after implantation of radioactive seeds into the prostate can I resume exercise or other vigorous activities?
The insertion of the needles causes some trauma to the vessels surrounding the prostate. Therefore, immediately after the implant, any exercise or activity that puts pressure on the prostate should be avoided. You should avoid lifting heavy objects or doing vigorous exercise for at least three to four days after the implant. Very vigorous exercise after this period may cause some minor bleeding in the bladder. This is not harmful, but you should limit your exercise until the bleeding stops. Activities such as bike riding, horseback riding, motorcycle riding in which there is pressure on the prostate should be avoided for at least six months. The repetitious jarring of the prostate with these activities can cause some swelling and impair urination.

Will I be radioactive after the seed implantation?
No. Although the seeds are radioactive, patients are not. Because the radioactivity is so low and the placement is so precise, virtually all the radioactivity is absorbed into the prostate. However, special precautions should be taken when a patient is in contact with small children and pregnant women in the first two months after treatment. You nurse or doctor will advise you what precautions are necessary and when.

Does the radiation from seed implants pose any danger to my sexual partner?
No, the seeds are of low energy and pose little risk to your partner. The semen is not radioactive. You may resume sexual activity very soon after the procedure. Occasionally, there may be blood in the semen or some slight pain at climax.